Andy Burnham’s speech a chance to flesh out the fundamental problem of the health and care needs of the population

Karen Noakes, ACEVO’s Head of Health Policy and Services, writes about Andy Burnham’s upcoming keynote address at the upcoming ACEVO Health and Social Care Conference and what we can expect from Labour’s health plans:

The Shadow Secretary of State for Health, Andy Burnham MP, will give the keynote speech at ACEVO’s Health and Social Care Conference this month. Its timing couldn’t be better. With Labour’s Whole Person Care Report published by Sir John Oldham last week, we have glimpsed a potential blueprint for Labour’s future health and social care policy in the run up to the 2015 election.

Labour describes the report as a call for change that is evolutionary, not revolutionary.

It aims to remove the obstacles currently holding the NHS back from the reform it needs, while recognising that another top-down reorganisation could do more harm than good. Those of us who have worked in the health sector for a while, and who might think there has been quite a lot of change (if only organisational) over the last few years, may be relieved to note its sensitivity to the impact of big-scale change.

The report itself covers pretty well trodden ground on “the case for change”. Andy Burnham’s speech to our conference will give him the chance to flesh out some of the recommendations that Sir John and the Independent Commission make to address a fundamental problem: the health and care needs of the population have changed much faster than the systems that are there to support them.

So, we’re left asking a simple question: how do we effect radical change, without radically changing the system? And how far will politicians acknowledge the central role of the voluntary sector in all this?

The report is set apart from the Government’s vision (the case for integrated person-centred care, increased engagement with patients and the public, self-care, co-production, information sharing) by these main points:

• Primary care services are to be extended in their range and scope to provide more coordinated services for people in the community and at home;

• A substantial revision of existing training and education to facilitate multidisciplinary training including joint leadership training between health and social care.  Also a rebalancing of specialist and generalist knowledge to best meet people’s increasing multiple health needs;

• Recognition of the role of specialist expertise beyond the confines of hospital buildings;

• Episodic payment systems (such as Payment by Results) to be replaced by a “whole person payment system”;

• Flexibility to allow local decisions to be made on forming a single health and social care budget;

• New models of care delivery e.g. Accountable care organisations (ACOS) that require a number of providers of care to collectively achieve outcomes for a defined population group under a single contract.

• Some changes of the current system suggested to address current fragmentation and silo working at the national and local level – NHS England to be renamed Care England, Monitor and CQC to merge;

• The strengthening of health and wellbeing boards to take on a stronger strategic role locally.

The report also recommends an independent “National Conversation” on what health and social care should be, how and where it should be delivered, and how to pay for it.  It would happen within a year of the general election. This is a good idea but we’ll have to wait, again, to see how it might happen and how meaningful the discussion will really be.

It is important for citizens to be involved as much as possible in the future design of our health and care system.  There is an obvious role for the voluntary sector in supporting these conversations and in delivering Whole Patient Care. The voluntary and community sector has occupied this space for some time.

We are well used to taking on local coordination roles and working collaboratively, supporting people in their own homes and communities and championing Whole Person Care. Our collective expertise will be essential in transforming the health and social care system, and it will be interesting to see how far Andy Burnham acknowledges this in his vision of real reform without radical change.

The party’s recognition of our sector will be a test of how serious they are about whole person care.

Hope to see you at the conference.

The ACEVO Health and Social Care Conference 2014 will be held at Dexter House, London on Tuesday 25 March. To book your place, go to www.acevo.org.uk/health2014

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